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Ontario home care to see $750M in improvements

Home-care recipients to have more control about who is their personal support worker and when that support is given.

Ontario Health Minister Eric Hoskins says the current provincial home-care system is "patchy, uneven and fragmented." In announcing $750-million in improvements, he noted that the first step is to make it more responsive to the needs of patients and caregivers. (Chris Young / THE CANADIAN PRESS)

A critical home-care report, authored by an expert panel and released in March, said the system is frustrating — not just to patients and families whom it fails — but also to funders and providers. It called for making home- and community care more accountable, transparent and co-ordinated.

Hoskins said his plan for transforming the sector delivers on every recommendation made in that report. It will be funded to the tune of $750 million over three years, first announced in last month’s budget.

Recipients of home care often complain that their personal support workers (PSWs) keep changing. As well, they say that the scheduling of care is rigid and set by home-care agencies.

“We are going to begin to offer self-directed funding where, for example, certain clients would be given their funding directly so that they have the flexibility to hire the PSW or nurse of their choice and set a schedule that is convenient and works for them,” Hoskins said.

This is one of a number of self-directed models of care that the health ministry plans to pilot in the next couple of years.

The province plans to better integrate care for patients moving out of hospital and into the community in response to criticisms that different parts of the health system work at odds with each other.

It will build on the success of a demonstration project at St. Joseph’s Health System in Hamilton where the same health-care team works with a patient whether in hospital or at home. This will be supported by a new funding model called “bundled care.”

Hoskins also announced plans to increase supports for caregivers, boost nursing services, improve access to palliative and end-of-life care, and to address inconsistencies in the level of home- and community care across the province.

He steered clear of discussing the fate of the province’s 14 community care access centres, which co-ordinate home- and community care in different regions of the province. Critics have called for them to be scrapped.

“Form should follow function. I believe the most important first steps need to be to provide that improved, seamless, integrated, uniform care to patients,” he said

Hoskins said structural questions can be addressed later and noted that the provincial auditor is soon expected to release a report on CCACs.

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